Mycobacterium tuberculosis remains one of the most devastating human infectious diseases, causing two million deaths annually and latently infecting a third of the world's population. As an intracellular pathogen adapted to long-term survival, M. tuberculosis has evolved mechanisms to resist killing by host antimicrobial pathways. Targeting those resistance mechanisms has recently emerged as a powerful new approach to treating M. tuberculosis infection by enhancing the host's ability to eradicate the bacteria. However, the full repertoire of mycobacterial resistance genes is not known, and expanding this knowledge base provides additional avenues for the development of new drugs. We demonstrated the M. tuberculosis induces an enzyme, heme oxygenase, that produces carbon monoxide (CO) gas, and that M. tuberculosis both adapts to and resists killing by CO. We hypothesized that M. tuberculosis evolved genes for CO resistance, and our preliminary data indicate that M. tuberculosis encodes one such gene that when mutated results in attenuated virulence. We will apply metabolomic, transcriptomic, proteomic, and biochemical approaches to determine the function of the newly discovered CO resistance protein. Thus, in the proposed research we will (1) identify the molecular mechanism of CO resistance, (2) determine the interacting partners of the CO resistance gene and their role in CO resistance and (3) characterize the pathogenic effects of mutants in the CO resistance gene and its interacting partners. The proposed work will extend the current knowledge on M. tuberculosis's antimicrobial resistance mechanisms and reveal a novel microbial survival strategy. PUBLIC HEALTH RELEVANCE: Tuberculosis is a major human pathogen, accounting for significant morbidity and mortality worldwide. Work outlined in this proposal will investigate a novel mechanism that allows M. tuberculosis to survive and persist within humans. We expect that this work will help identify new potential drug targets for the treatment of tuberculosis. PUBLIC HEALTH RELEVANCE: The mechanisms used by Mycobacterium tuberculosis to survive within the host are incompletely understood. We propose to study how M. tuberculosis survives exposure to carbon monoxide, a toxic gas produced by host macrophages, focusing on the mycobacterial gene Rv1829 that we identified in a screen for CO resistance mutants. This approach is novel because it represents the first description of a CO resistance gene in a major human pathogen.